Provider Demographics
NPI:1255208617
Name:HALL, MARLOW GENE III
Entity type:Individual
Prefix:
First Name:MARLOW
Middle Name:GENE
Last Name:HALL
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12964 COUNTY ROAD 90
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-9385
Mailing Address - Country:US
Mailing Address - Phone:419-673-6013
Mailing Address - Fax:
Practice Address - Street 1:12964 COUNTY ROAD 90
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-9385
Practice Address - Country:US
Practice Address - Phone:419-673-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant